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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/14 09:37:50」(JST)
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| Systematic (IUPAC) name | |
|---|---|
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(RS)-1-chloro-2-[2,2-dichloro-1-(4-chlorophenyl)-ethyl]-benzene
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| Clinical data | |
| Trade names | Lysodren |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a608050 |
| Licence data | US FDA:link |
| Pregnancy category |
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| Legal status |
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| Routes of administration |
Oral |
| Pharmacokinetic data | |
| Bioavailability | 40% |
| Protein binding | 6% |
| Biological half-life | 18 to 159 days |
| Identifiers | |
| CAS Registry Number | 53-19-0 Y |
| ATC code | L01XX23 |
| PubChem | CID: 4211 |
| IUPHAR/BPS | 6957 |
| DrugBank | DB00648 Y |
| ChemSpider | 4066 Y |
| UNII | 78E4J5IB5J Y |
| KEGG | D00420 Y |
| ChEMBL | CHEMBL1670 Y |
| Chemical data | |
| Formula | C14H10Cl4 |
| Molecular mass | 320.04 g/mol |
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InChI
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| Y (what is this?) (verify) | |
Mitotane, also known as o,p'-DDD (Lysodren), is an antineoplastic medication used in the treatment of adrenocortical carcinoma.[1] It is an isomer of DDD and is a derivative of DDT.[2] Its main use is in those patients who have persistent disease despite surgical resection, those who are not surgical candidates, or those who have metastatic disease.
It has been produced by Bristol Myers Squibb SpA but it is marketed as an orphan drug due to the small number of patients in need of it. A 2007 study of 177 patients shows a significant increase in the recurrence-free interval after radical surgery followed by mitotane when compared to surgery alone.[3]
Mitotane alters steroid peripheral metabolism, directly suppresses the adrenal cortex and alters cortisone metabolism leading to hypocortisolism. Side effects as reported by Schteinberg et al. include anorexia and nausea (88%), diarrhea (38%), vomiting (23%), decreased memory and ability to concentrate (50%), rash (23%), gynecomastia (50%), arthralgia (19%), and leukopenia (7%).[4]
Its trade name is Lysodren.
Veterinary use
Mitotane is also used to treat Cushing's disease (pituitary-dependent Cushing's syndrome) in dogs. The medication is used in the controlled destruction of adrenal tissue, leading to a decrease in cortisol production.[5]
References
- ^ Hahner S, Fassnacht M (April 2005). "Mitotane for adrenocortical carcinoma treatment". Current opinion in investigational drugs (London, England : 2000) 6 (4): 386–94. PMID 15898346.
- ^ Information from PubChem
- ^ Terzolo M, Angeli A, Fassnacht M, Daffara F, Tauchmanova L, Conton PA, Rossetto R, Buci L, Sperone P, Grossrubatscher E, Reimondo G, Bollito E, Papotti M, Saeger W, Hahner S, Koschker AC, Arvat E, Ambrosi B, Loli P, Lombardi G, Mannelli M, Bruzzi P, Mantero F, Allolio B, Dogliotti L, Berruti A (2007). "Adjuvant mitotane treatment for adrenocortical carcinoma". N Engl J Med. 356 (23): 2372–2380. doi:10.1056/NEJMoa063360. PMID 17554118.
- ^ Schteinberg DE, Motazedi A, NoonanRA, Thompson NW (1982). "Treatment of Adrenal Carcinomas". Arch.Surg. 117: 1142–1149.
- ^ Canine Cushing’s Syndrome: Diagnosis and Treatment
External links
- V. P. Komissarenko1, I. S. Chelnakova and A. S. Mikosha (1978). "Effect of o,p-dichlorodiphenyldichloroethane and perthane in vitro on glutathione reductase activity in the adrenals of dogs and guinea pigs". Bulletin of Experimental Biology and Medicine 85 (2): 152–154. doi:10.1007/BF00800110.
- Government of Canada: Benzene, 1-chloro-2-[2,2-dichloro-1-(4-chlorophenyl)ethyl]- (Mitotane)
- Environment Canada & Health Canada: RISK MANAGEMENT SCOPE for Benzene, 1-chloro-2-[2,2-dichloro-1-(4-chlorophenyl)ethyl]- (Mitotane), 2013
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UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
- 1. 副腎皮質癌の治療 treatment of adrenocortical carcinoma
- 2. 副腎皮質機能亢進症の内科的治療（クッシング症候群） medical therapy of hypercortisolism cushings syndrome
- 3. 副腎酵素阻害剤および抗アドレナリン薬の薬理および毒性 pharmacology and toxicity of adrenal enzyme inhibitors and adrenolytic agents
- 4. 妊娠中のクッシング症候群 cushings syndrome in pregnancy
- 5. 精巣性索間質腫瘍 testicular sex cord stromal tumors
English Journal
- Therapeutic drug monitoring of mitotane: Analytical assay and patient follow-up.
- Feliu C1, Cazaubon Y1, Guillemin H1, Vautier D1, Oget O1, Millart H1, Gozalo C1, Djerada Z1.
- Biomedical chromatography : BMC.Biomed Chromatogr.2017 Nov;31(11). doi: 10.1002/bmc.3993. Epub 2017 May 21.
- PMID 28432798
- Circannual variation of mitotane and its metabolites plasma levels in patients with adrenocortical carcinoma.
- Cusato J1, De Francia S2, Allegra S1, Carrella S2, Pirro E2, Piccione FM2, De Martino F2, Ferrero A3, Daffara FC4, Terzolo M4, Berruti A5, Di Carlo F2, Tampellini M3, D'Avolio A1.
- The Journal of pharmacy and pharmacology.J Pharm Pharmacol.2017 Nov;69(11):1524-1530. doi: 10.1111/jphp.12798. Epub 2017 Aug 15.
- PMID 28809444
Japanese Journal
- 症例 転移性副腎がんの1例
- 原野 謙一
- 腫瘍内科 9(4), 455-458, 2012-04
- NAID 40019314884
- Contralateral pleural recurrence of adrenocortical carcinoma after surgical resection
- INAGE Eisuke,SAITO Masahiro,SAITO Yohei,TAKATA Oto,FUJIMURA Junya,YAMATAKA Atsuyuki,SHIMIZU Toshiaki
- Pediatrics international : official journal of the Japan Pediatric Society 53(4), 600-603, 2011-08-01
- NAID 10029559393
Related Links
- mitotane is lifelong due to the underlying cause of the hyperadrenocorticism (i.e., pituitary tumor or dysfunction) not being addressed. ＜下垂体依存性副腎皮質機能亢進症＞ PDHの導入療法は40 から 50 mg/kg/day PO の一日量を ...
- BACKGROUND: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis and limited therapeutic options. Mitotane is considered the standard first-line therapy with only 30% of the patients showing objective tumour ...
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| リンク元 | 「ミトタン」 |